Abstract
Refractory celiac disease (RCD) is defined by persistent symptoms of malabsorption and villous atrophy despite a 8-12 months strictly gluten free diet, in the absence of other causes of unresponsiveness to diet or malignancies. RCD can be classified into two types: intestinal bioptic samples of RCD type 1 show an intraepithelial lymphocytic infiltrate with normal phenotype, in contrast with RCD type 2 where intestinal lymphocytes are aberrant. RCD type 1 is usually characterized by clinical improvement using a treatment strategy that includes nutritional support, gluten free diet and immunosuppressive drugs; RCD type 2 does not benefit from this therapy and shows poor prognosis and elevated risk of developing EATL. The description of this case is due to improve our knowledge on alternative therapeutic strategy for the treatment of RCD in patients with refractory celiac steroid-unresponsive.
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